tbuckley/cabot-search huggingface dataset:
AB1562 NAIL FOLD CAPILLAROSCOPY IN EVALUATING INTERSTITIAL LUNG DISEASE OF RHEUMATOID ARTHRITIS, SYSTEMIC SCLEROSIS AND IDIOPATHIC TYPE
Authors: S. Rashad, K. Darwish, H. Abdel-Maksoud, A. Abas, M. Abdelaty
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Nail fold capillaroscopy (NFC) is a non invasive diagnostic tool to detect early changes of microcirculation of different collagen diseases as rheumatoid arthritis associated interstitial lung disease (RA-ILD), systemic sclerosis interstitial lung disease (SS-ILD) and idiopathic ILD (Ting et al., 2020). <h3>Objectives</h3> The study aimed to evaluate role of NFC in RA-ILD, SS-ILD and idiopathic ILD, and to determine if there is a correlation of it to disease activity. <h3>Methods</h3> A case control study conducted on 100 patients with ILD, where 30 patients with RA-ILD, 30 patients with SS-ILD and 40 patients with idiopathic-ILD, fulfilling ACR/EULAR criteria, 2013. They were examined clinically and radiologicaly. Pulmonary function tests (PFT) and NFC were done. <h3>Results</h3> Pleural irregularities were found in 42% of RA-ILD, 30% of SS-ILD where subpleural irregularities were found in 31% of RA-ILD and 46.7% of SS-ILD. Ground glass opacity was in 13% of RA-ILD, 76.7% in SS-ILD and70% in idiopathic –ILD. Honeycomb appearance was in 11.5% of RA-ILD, 30% in SSILD and 65% of idiopathic ILD.SS-ILD showed the highest capillary changes especially patients with pneumonia. A significant correlation was found between NFC and PFT in idiopathic-ILD. <h3>Conclusion</h3> NFC is a sensitive and specific adjuvant tool in monitoring micro vascular changes in rheumatologic diseases and can be used as assessment tool in severity of the disease. <h3>Reference</h3> [1]Ting Z, Lin F and Chen H (2020): Pattern of NFC in patients with SLE. Archives of Rheumatology, 35(4), 568 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1433 FACTORS ASSOCIATED WITH DIAGNOSIS DELAY IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS
Authors: L. Kharrat, H. Ferjani, D. Ben Nessib, K. Maatallah, D. Kaffel, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The diagnosis delay is very variable in Juvenile Idiopathic Arthritis (JIA). The duration between the occurrence of symptoms, the diagnosis time, and the establishment of the treatment is very important in disease progression. <h3>Objectives</h3> To determine the diagnosis delay in JIA and study the factors affecting this delay. <h3>Methods</h3> We conducted a retrospective study including patients with Juvenile Idiopathic Arthritis (JIA) meeting the International League of Associations for Rheumatology (ILAR) 2001 criteria. For each patient, we collected the following data: age, gender, age at the onset of JIA, JIA subtype, diagnosis delay, clinical examination data, extra-articular manifestations, C-reactive protein (CRP) and Erythrocyte sedimentation rate (ERS) levels. Disease activity was assessed using the JADAS score. Statistical analysis was performed using SPSS software. <h3>Results</h3> We included 44 patients. They were 28 boys and 16 girls. The mean age was 13.65 ± 4.62 years. The mean age at the onset of the disease was 9.57 ± 3.97 years. The mean diagnosis delay was 4.34 ± 3.09 years. There was enthesitis-related arthritis in 61% of the cases (n=27), oligoarticular JIA in 14% of the cases (n=6), polyarticular JIA in 11% of the cases (n=5), and psoriatic arthritis in 7% of the cases (n=3). JIA was undifferentiated in 7% of the cases (n=3). The mean tender and swollen joint counts were 1.46 ± 2.33 and 0.17 ± 0.54, respectively. Fourteen patients had clinical enthesitis (32%). Sacroiliac joints were painful in 15 patients (34%). Fifteen patients had low back pain (34%). Only 4 patients had extra-articular manifestations (2 psoriasis and 2 uveitis). The mean CRP and ESR were 14.42 ± 19.67mg/L and 26.56 ± 20.87mm, respectively. The mean JADAS was 6.6 ± 4.7, respectively. The diagnosis delay was positively correlated to the patient's age (r=0.561, p&lt;10<sup>-3</sup>) and negatively correlated to the ESR level (r=-0.331, p=0.037). Besides, diagnosis delay was associated with extra-articular manifestations (4.45 ± 3.12 versus 2±0.1 years, p&lt;10<sup>-3</sup>). Besides, ERA patients had longer diagnosis delay compared to other JIA subtypes but the difference was not significant (p=0.061). However, diagnosis delay was not associated with low back pain, enthesitis, or sacroiliac joint pain. <h3>Conclusion</h3> Our results are consistent with Kurt et al. study [1]. Older age, the occurrence of extra-articular manifestations, and low ESR level could lead to diagnosis impediment. <h3>Reference</h3> [1] Kurt T, Tekin ZE, Çelikel E, et al. Evaluation of the time of patients' admission to the tertiary pediatric rheumatology center for juvenile idiopathic arthritis. <i>ARP Rheumatol</i>. 2022;1(4):286-292. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1582 DEPRESSION IN RHEUMATOLOGIST FROM LATIN AMERICA
Authors: M. Intriago, G. Maldonado, E. Soriano, C. Rios
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Depression, burnout, and suicide are becoming a major problem among physicians. A survey estimated that around 21% are depressed and 1 in 10 had have suicidal thoughts.<sup>[1]</sup> <h3>Objectives</h3> Determine the prevalence of depression in rheumatologists from Latin America and factors associated with it. <h3>Methods</h3> Cross-sectional study. Data was collected through an online survey distributed by PANLAR, which included demographics and work-related factors. Depression was measured with PHQ-9 questionnaire, burnout with the Maslach Burnout Inventory, happiness with the Subjective Happiness Scale and satisfaction with a 7-point Likert scale. Analysis of data was done with SPSS V 27 and included descriptive statistics and association between variables using Chi square and Student's T test. <h3>Results</h3> 297 rheumatologists were included from 15 countries, mainly Argentina 28.3% and Brazil 26.3%. Most were women 62%, married 65%, practiced adult rheumatology 82% and earned less than $50 K/year 74.8%. Depression was found in 48.8%: mild 33%, moderate 8.8%, moderate severe 4%, severe 3%. The mean PHQ-9 score was 5.5±5.3. 46.1% reported anhedonia, 40.7% feeling depressed, sleep alterations 57.2%, fatigue 75.1%, appetite changes 46.1%, feelings of failure 37%, decreased concentration 50.2%, psychomotor changes 27.9%, thoughts of hurting oneself 9.8%, 8.2% suicidal thoughts and 8.4% low self-esteem. 56.6% had burnout. 14.5% were taking SSRI/SNRIs and 4% were previously diagnosed. Factors associated with depression were female sex (p=0.008), younger age (p&lt;0.001), administrative duties (p=0.010), annual income less than $25K (p=0.002), low self-esteem (p&lt;0.001), burnout (p&lt;0.001), less satisfaction with career (p&lt;0.001) and lower subjective happiness (p&lt;0.001). Exercise (p=0.035) and practicing academics (p=0.010) were associated with less depression. <h3>Conclusion</h3> Depression affected almost half of the rheumatologists and was more common in females, younger population, with low self-esteem. Lower income, having burnout and less satisfaction with the career were also risk factors. Only a small proportion of the affected population was previously diagnosed and on treatment. <h3>Reference</h3> [1] Yasgur, B. A Tragedy of the Profession: Medscape Physician Suicide Report 2022. Medscape. Available at https://www.medscape.com/slideshow/2022-physician-suicide-report-6014970. 2022/03/04; Accessed: 01/10/23. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1537 CAN WE DIFFERENTIATE PATIENTS WITH DYSFERLINOPATHIES AND INFLAMMATORY MYOPATHIES BY MUSCLE ULTRASOUND? A DISCRIMINANT ANALYSIS STUDY
Authors: C. Soto, S. Y. Solorzano Flores, F. Carranza-Enriquez, A. Angeles-Acuna, R. E. Escobar-Cedillo, C. Pineda
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Immune-mediated myopathies (IMM) are a heterogeneous group of diseases characterized by inflammation and muscle weakness; among their differential diagnoses are the dysferlinopathies, which are autosomal recessive neuromuscular disorders caused by mutations in the DYSF gene that present muscle weakness and significant increase of CK, just like IMM. <h3>Objectives</h3> Determine the sonographic differences between dysferlinopathies and immune-mediated myopathies and whether these allow their classification. <h3>Methods</h3> Observational, cross-sectional, and analytical study in which we evaluated 20 muscles from 11 patients with dysferlinopathies and 11 with inflammatory myopathies according to current classification criteria. They were matched for age, sex, and time of disease evolution. Clinical and laboratory variables were analyzed. GE LOGIQ<sup>TM</sup>e equipment with a 4-12 MHz linear transducer was used, and the thickness of each muscle was measured. A semiquantitative scale evaluated elementary lesions: atrophy, edema, power Doppler, and the Heckmatt scale (0-4) was calculated. Descriptive statistics were performed using measures of central tendency and dispersion according to the distribution of the variables, followed by bivariate analysis (Student's t-test and Chi<sup>[2]</sup> test). Finally, discriminant analysis was performed to determine which ultrasound variables best predicted the diagnoses. <h3>Results</h3> A total of 40 muscles were evaluated, finding a greater degree of atrophy and a higher Heckmatt scale in patients with dysferlinopathies compared to MII. Discriminant analysis showed that the set of 3 muscles, Right biceps/brachialis (BB), Right quadriceps (CD), and Gastrocnemius/right soleus (GC), had a diagnostic accuracy of 100% (sensitivity 100%, specificity 100%, canonical coefficient 0.733 p=.000). We present a set of 2 formulas that allow classifying with the highest score according to the measurement of the muscles in group 1 (dysferlinopathy) or group 2 (MII). Finally, a COR analysis was performed to determine the cut-off points of each muscle to classify as dysferlinopathies. <h3>Conclusion</h3> The study of 3 muscle groups (BB, CD, GC) presents high diagnostic accuracy to differentiate dysferlinopathies from MII, especially when there is no genetic study or antibodies available, and there is diagnostic doubt. <h3>Reference</h3> [1]Izumi R, Takahashi T, Suzuki N, Niihori T, Ono H, et al. The genetic profile of dysferlinopathy in a cohort of 209 cases: Genotype-phenotype relationship and a hotspot on the inner DysF domain. Hum Mutat. 2020; 41(9):1540-1554. doi: 10.1002/humu.24036. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1423 USE OF BIOSIMILAR THERAPIES IN ADULT PATIENTS DIAGNOSED WITH JUVENILE IDIOPATHIC ARTHRITIS: RESULTS FROM THE SPANISH REGISTRY OF ADVERSE EVENTS WITH BIOLOGIC THERAPIES (BIOBADASER)
Authors: J. J. Bethencourt Baute, L. Otero-Varela, F. J. Manero Ruiz, E. Perez-Pampín, C. Rodríguez-Lozano, S. Manrique Arija, S. Bustabad, C. Fernández-López, D. Ruiz Montesinos, L. Mateo, R. Martín-Domenech, M. Moreno, F. Sánchez-Alonso, I. Catrejón
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in childhood. The emergence of new biological drugs has changed the prognosis and therapeutic approach to these patients, and costs are reduced with the use of biosimilar disease modifying antirheumatic drugs (bsDMARD). <h3>Objectives</h3> Our aim was to describe the use of bsDMARD therapies in JIA. <h3>Methods</h3> Data was obtained from the nationwide prospective registry BIOBADASER. All patients diagnosed before age 16 in our database between 2000 and 2022 were included in the analysis. JIA is classified into 7 subgroups: systemic, persistent or extended oligoarthritis, RF positive polyarthritis, RF negative polyarthritis, enthesitis-related arthritis, psoriatic arthritis, and undifferentiated arthritis. Due to the registry design, it was not possible to identify each of the JIA subgroups; thus, we classified them into oligo/polyarticular JIA, JIA related to enthesitis, and psoriatic JIA. Proportions, means and standard deviations (SD) were used to describe our population and the utilization of treatments. Drug persistence was calculated using Kaplan-Meier survival curves until termination of treatment due to any reason. <h3>Results</h3> From a total of 313 patients, 130 patients (41.5%) received 151 treatments with bsDMRAD, 60.8% of which were women (n= 79). Mean age at diagnosis was 11.2 years (SD= 6.1) and mean age at the beginning of treatment was 25.1 (SD= 13.4). Patients were classified as oligo/polyarticular JIA (79.2%), JIA related to enthesitis (16.2%) and psoriatic JIA (4.6%). Methotrexate was used in combination in 39.1% of the biosimilar treatments. The most commonly used drug was Adalimumab (56.8%), followed by Etanercept (28.7%). Table 1 shows the biologic therapies used in our sample and the reasons for discontinuation. The median survival rate with the biosimilar drug and original was similar. <h3>Conclusion</h3> Adalimumab were the most commonly used biosimilar therapy in JIA. Ineffectiveness was the main reason for discontinuation. There were no differences on 5 years survival rates, which is a crucial endpoint in JIA. <h3>References</h3> [1] Aragon Cuevas, O; Hedrich Christian M. Biosimilars in pediatric rheumatology and their introduction into routine care. Clinical Immunology 216 (2020) 108447 [2] Maccora I, et al. OBSIDIAN - real-world evidence of originator to biosimilar drug switch in juvenile idiopathic arthritis. Rheumatology (Oxford) Volume 61, Issue 4, April 2022, Pages 1518–1528 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0876 IMPACT OF AUTOANTIBODY PROFILE ON FUTURE ORGAN INVOLVEMENT IN SYSTEMIC SCLEROSIS: DISEASE FREE SURVIVAL IN DIFFERENT PATIENT GROUPS
Authors: M. Can, B. Demir, N. Aliyeva, S. Amikishiyev, B. Artim-Esen, A. Gul, M. Inanc, Y. Yalçinkaya
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Some specific autoantibodies were known to be associated with cutaneous subtype, type of organ involvement and prognosis in systemic sclerosis (SSc). <h3>Objectives</h3> The aim of our study was to evaluate the impact of autoantibody profile on the course of SSc regarding new organ involvement over time. <h3>Methods</h3> The data of 206 consequitive patients (189 women) with SSc who were followed up at least 12 months were retrospectively analyzed. Associations between the autoantibodies (anti-nuclear antibody (ANA) (27.7%, n=57), anti-Scl70 (47.1%, n=97) and anti-centromere (ACA) (22.3%, n=46)) and disease-free survival (without new organ involvement) were evaluated in SSc patients with a mean follow-up time of 101.26±71.02 months. <h3>Results</h3> Anti-Scl70 was associated with diffuse cutaneous disease involvement, digital ulcers, arrhythmia, and interstitial lung disease (ILD) (OR:3.43, p&lt;0.001, OR:1.835, p=0.033, OR:4.06, p=0.038 and OR:2.393, p=0.006, respectively). ACA was associated with PAH (OR:3.319, p=0.040) and protective against diffuse skin involvement, flexion contractures and ILD (OR:0.203, p=0.001, OR:0.251, p=0.012 and OR:0.288, p=0.008, respectively). In ACA (+) group, new organ involvement was observed less frequently (HR: 0.523 (95% CI (0.29-0.94), p=0.030) and after a longer time period when compred to ACA (-) group (82.65±14.5 vs 53.98±5.49 months, p=0.026). At the 5th and 8th years of the follow-up, half of the ACA(+) patients did not develop new organ involvement. In the ACA(-)[(ANA(+) or antiScl70(+)] group, new organ involvement was detected in &gt;67% within 5 years and in &gt;80% within 8 years (figure-1, table-1). <h3>Conclusion</h3> Although ACA(+) patients are considered to have a better prognosis, some patients may develop new or worsening manifestations after a longer time period. The prognosis of ANA or anti-Scl70(+) patients was shown to be more severe and most patients had new organ involvement within the first 5 years of the disease, warranting a careful evaluation and efficacious treatment at this period. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1435 RELEVANCE OF AUTO-ANTIBODIES AGAINST CARBAMYLATED PROTEINS IN JUVENILE IDIOPATHIC ARTHRITIS
Authors: M. Thomas, G. Martinroche, A. Combier, J. Wipff, G. Touanga, P. Quartier, C. Bordes, M. E. Truchetet, Y. Allanore
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Auto-antibodies against carbamylated proteins (anti-CarP) are emerging biomarkers in rheumatoid arthritis with relevant prognostic value. Juvenile idiopathic arthritis (JIA) is characterized by high heterogeneity and risk-stratification could be improved. <h3>Objectives</h3> We aim at determining whether anti-CarP in J IA's patient, at the time of transition, could help to predict patients' outcomes. <h3>Methods</h3> We conducted a monocentric retrospective study at the Cochin Hospital in Paris on a cohort of JIA patients in transition to adult rheumatology for whom serum has been collected and stored in a biobank between 2011 and 2013 with the approval of research ethic committee (EUDRACT 2010-A01386-33, reference S.C.2852). Demographic data, diagnosis, biological and radiological results, and treatments were collected retrospectively thanks to computerized files. Samples of serum available in the biobank were analyzed to measure anti-CarP and anti-CCP by ELISA in the department of Immunology and Immunogenetic from the Bordeaux University Hospital. <h3>Results</h3> Twenty-eight (20%) patients were anti-CarP positive. The median age was 21.6 (18.6-23.1) years in anti-CarP positive as compared to 19 (17-21.1) in anti-CarP negative group (p=0.02). In anti-CarP positive group, 41% were polyarticular-JIA, 26% oligoarticular, 15% had enthesitis related arthritis and 15% were systemic, but this was not different as compared to anti-CarP negative patients. Structural radiographic damages were identified in 44% of anti-CarP positive such as in 50% in anti-CarP negative group (p=0.6). Concerning treatment, 28% of anti-CarP positive patients were treated with synthetic DMARD and 72% with biologic DMARD as compared to 44% (p=0.1) and 65% (p=0.5) for anti-CarP negative. Among anti-CarP positive patients, 10 (7.4%) were also anti-CCP positive. These double-positive patients were polyarticular-JIA for 90% and 9 (90%) received a biotherapy at the last available follow-up as compared to 16% of polyarticular-JIA (p=0.002) and 44 (46%) on biotherapy (p=0.03) for double negative. <h3>Conclusion</h3> Anti-CarP antibodies were observed in 20% of JIA's patients at transition but could not help for risk-stratification of the patients. The respective value of anti-CarP and anti-CCP for structural damages and treatment intensification will require larger cohort but double positive patients appeared to be the most severe polyarticular-JIA patients. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1573 AUTOIMMUNE HEMOLYTIC ANEMIA IN CHRONIC LIVER DISEASES
Authors: N. Trad, G. Mohamed, S. Bizid, S. Soua, B. Ben Slimen, K. Boughoula, H. Ben Abdallah, R. Bouali, M. N. Abdelli
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Chronic liver diseases can be associated with autoimmune diseases. their association with autoimmune hemolytic anemia (AIHA) is poorly studied. <h3>Objectives</h3> Our objective was to study the prevalence and the characteristics of AIHA in chronic liver diseases. <h3>Methods</h3> We performed a retrospective analysis of data from consecutive patients followed in our department for chronic liver diseases recruited from January 2010 to December 2019. The diagnosis of AHAI was retained in front of regenerative anemia with a positive direct coombs test and stigmata of hemolysis (free hyperbilirubinemia, elevated lactate dehydrogenase, and low haptoglobin) in the absence of other overt causes of constitutional or acquired hemolysis. <h3>Results</h3> A total of 187 patients were included with an average age of 60.2 years [11-89] and a sex ratio of 1.79. Thirteen patients had an AIHA (7%). Anemia was normocytic in 77% of cases and macrocytic in 23% of cases. Five patients had a history of associated autoimmune pathologies (38.4%); autoimmune thyroiditis in two cases, one case of psoriasis, one case of Sjögren's syndrome and one case of autoimmune thrombocytopenia The AIHA was more frequent in cases of viral chronic liver diseases B and C (46.1%). Three patients had non-viral chronic liver diseases (23%): primary biliary cholangitis, autoimmune hepatitis, and alcohol. <h3>Conclusion</h3> In our study, AIHA was present in seven percent of cases, which would underline the importance of evoking it in the face of any anemia in the case of chronic liver diseases. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1355 EFFECT OF COVID-19 VACCINES ON ACTIVITY OF AUTOIMMUNE RHEUMATIC DISEASES
Authors: M. A. Mahmoud Besar, A. Abd El Salam
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The SARS-CoV-2 pandemic has paralyzed the world, Patients with autoimmune rheumatic diseases (AIRDs) are at high risk for SARS-CoV-2 infection[1]. Worldwide vaccination campaigns, which have increasingly built up immunity in this populations. Studies on the efficacy and safety of the vaccines have shown rapid and strong development of immunity in healthy populations and AIRDs [2]. <h3>Objectives</h3> To evaluate COVID-19 vaccination status in patients with autoimmune rheumatic diseases (AIRDs) whether receiving primary and booster vaccination and its relation to disease activity. <h3>Methods</h3> An observational cross section study conducted on a total number of 282 subjects divided into 2 groups: group (I): 179 vaccinated AIRD patients and group (II): 103 non-vaccinated AIRDs patients where Complete COVID-19 vaccination history. Disease activity scores of AIRDs were measured pre to post vaccination. <h3>Results</h3> Most of studied group 63% were vaccinated, Pfizer vaccine was the most common 33%, Asterzinca 19%, Sinpharm/Sinovac 10%, while Moderna was the least the least type of vaccine 1%, Figure 1. Pfizer vaccine 46% was the most common booster type, Asterzinc 39%, Sinopharm/Sinovac 8% and Moderna vaccine 3% and 4% of studied group not received booster vaccination, Figure 2. Most of Rheumatic disease were vaccinated; 46.4% Rheumatoid arthritis 39.7% Systemic Lupus Erythematosus, 5% Bechet<sup>'</sup>s disease 3.9% Ankylosing Spondylitis and 2.8% Vasculitis. In vaccinated group, severity of disease activity was statistically significantly higher in post-vaccination than pre -vaccination, Table 1. <h3>Conclusion</h3> Pfizer vaccine was the most common vaccine in AIRDs. COVID-19 vaccination may induce flare of disease activity in AIRDs. <h3>References</h3> [1]Boekel L, Hooijberg F, van Kempen ZLE, et al. Perspective of patients with autoimmune diseases on COVID-19 vaccination. Lancet Rheumatol. 2021;3(4):e241-e243. [2]Cook C, Patel NJ, D'Silva KM, et al. Clinical characteristics and outcomes of COVID-19 breakthrough infections among vaccinated patients with systemic autoimmune rheumatic diseases. Ann Rheum Dis. 2022;81(2):289-291. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.